Homogeneous immunoglobulins in Ghanaians living in Accra, Ghana

Serum screening for homogeneous immunoglobulins (H-Ig) was done on 149 apparently healthy Ghanaians (aged 17-95 years) and 73 sick subjects who presented at the Korle-Bu Teaching Hospital from October 1999 to September 2000. Sera were screened by agarose gel electrophoresis and those with equivocal results were confirmed by immunoelectrophoresis. Immunoglobulin classes (IgG, IgA and IgM) and Bence Jones proteinuria were measured and determined by single radial immunodiffusion method and heating respectively. Total protein, albumin, calcium, uric acid, urea and creatinine were estimated on ACE chemistry autoanalyser. The laboratory profile of 5 Ghanaians with a picture of multiple myeloma and one with monoclonal gammopathy of undetermined significance drawn from the sick subjects (6 of 73) are presented. None of the 149 healthy subjects studied in three age groups (17-40; 41-64 and dollar 65 years) had H-Ig, and their serum IgG, IgA, IgM, urea, creatinine, uric acid, calcium, total protein and albumin levels were within the normal range. H-Ig were present in sera of 6 out of the 73 sick subjects (8.2%); 5 of them (4 males, 1 female) presented a picture of multiple myeloma. Three of these 5 patients had IgG, and the others IgA paraproteinaemia. All 5 patients had immunoparesis which was absent in the 6th patient (a male) who also had IgA paraproteinaemia (< 10 g/L), active bone marrow with < 2% mature plasma cells and no renal involvement. Results of bone marrow examination supported a diagnosis of multiple myeloma in the 3 patients with IgG paraproteinaemia, but were not available for the other two. Bence-Jones proteinuria was found in 2 (both with IgG paraproteinaemia) of 4 patients (50%) available for testing. Renal involvement was indicated in the 5 patients with a picture of multiple myeloma as urea and creatinine levels were significantly raised.